I had a crash course not long ago when I received a puncture wound over 1/2 inch deep in the middle of a one inch gash.

Since then I have made about 10 phone calls to different people (thank you Steph and Tara) about how to deal with it. Here is what I have learned, please feel free to add any info. This is just my personal experience.

First, foremost and MOST importantly: in most states reporting a bite is law. It may be law for both dogs and cats, but you'll have to check with your local health department. Dog is used throughout this post, but you can substitute cat and all the info is the same. A 'bite' is defined by contact by teeth that breaks the skin. if you are bitten by an unknown dog, a dog with an unverified vaccination record, a dog who has bitten before, a dog that is aggressive or if you are bitten while on the job, REPORT THE BITE. If you are bitten by a dog owned by a rescue (that you are fostering, etc) tell the rescue and follow their instructions. PERSONALLY, and this is JUST MY OPINION, a bite under known circumstances by an known dog, due to accident, play, handler error or training does not necessarily need to be reported. BE AWARE that not reporting a bite for any reason may be intentionally breaking of a law.

.5 (most important, and added before 1) Puncture wounds should NOT be stitched shut!!!!! I spoke to four medical professionals before I added this. If you get a bite when (not if) you go to the doctor, if they tell you they are going to stitch the wounds closed, tell them you do not want them stiched. If they insist, tell them you want a second opinion before they do it. Punctures heal from the inside out, and it can take a while. Stitching them seals in the germs and prevents them from draining. This is VERY VERY bad!!! Draining is essential for the wound to heal.

1. All puncture wounds are serious, and never ever just throw a band aid on them and ignore them - this can lead to serious infection and you could end up on IV antibiotics and in the hospital. If the infection spreads (and it will VERY quickly) you could lose a limb. That is NOT said for dramatic effect, an infection deep in muscle tissue can become very serious before it is detected.

2. bleeding / weeping is a good thing. if the puncture wound bleeds it is cleaning itself out. do not squeeze it or fuss with it, just let it bleed and clean itself. If it does not bleed get it treated by a doctor NOW. A closed puncture wound can abcess.

3. drainage is normal, it often looks like watery blood. the wound may 'weep' for weeks until it heals completely. Healing may take a looooong time, the wound heals from the inside out. The discharge is dead cells and lymph fluid. Leave it alone and let it drain.

4. wash it well and rinse it VERY well. Use antibiotic cream instead of ointment, keep it covered most of the time but let it be in open air for a while each day.

5. mild salt soaks make a big difference. use sea salt (not table salt) and warm water. it should be pretty mild, tast it and make sure it is 'no saltier than a potato chip' (kinda weird, but that's what I was told) soak for at least 30 minutes. Sea salt is available at some grocery stores and most health food stores.

6. make sure your tetanus shot is up to date (you need one every 10 years) and of course make sure the dog's shots are all up to date. ibuprophen or asprin will help keep swelling down. Ask for something stronger from your doctor if you want, most will give you a few pills at least.

7. if the wound area gets hard, overly swollen or has red streaks coming out of it get it looked at... NOW. Red streaks coming out of a wound site is an indication of serious infection, possibly cellulitis - and that is nothing to ignore. Deep muscle infections need treatment immediately, it is NOT out of the question to loose a limb or a large portion of a muscle, even with IV antibiotics in the hospital. This is NOT an exadduration, please take the wound VERY seriously. You may hear stories from 'tough guys' about thier 50 bite wounds that they rinsed out with whiskey, poked with a stick to make them drain and covered with duct tape. They played with a loaded gun and happened to win out. Don't be stupid. It's better to be overly cautious and not risk it.

8. get a 10 day course of antibiotics to help you ward off infection. there are gram negative and gram positive antibiotics (I think that is what they are called) so don't just use some you have left over from your last ear infection. The wrong kind can be ineffective.

9. because cats have long and somewhat thin canine teeth, the wounds tend to close up quickly. Cat bites can get VERY serious very quickly, moreso than dog bites. DO NOT FAIL TO HAVE A CAT BITE LOOKED AT BY A DOCTOR AS SOON AS POSSIBLE. I received a cat bite in the palm of my hand, and within an hour the swelling was bad enough that I could barely close it and I was getting red streaks up my wrist. a day on antibiotics made a big difference, but I did get an abcess that took a while to heal.

Last edited by mnp13 on June 12th, 2007, 11:40 am, edited 2 times in total.

This is very good information to keep here. My mom learned the hard way. She got bit by a stray cat on her finger. She was given a broad-spectrum antibiotic but this did not do the job. Make a long story short, she ended up with osteomyelitis on her finger (bone infection) and had to have some of the bone removed. Now she can no longer bend that finger but at least she still has it.

I just recently was bitten by a cat at work. I have 4 puncture marks that have now scarred and they were DEEP.
We have rules at work:

If you get bit, run it under water, let it bleed, let it bleed let it bleed. Then wash the wounds 3 times for 30 seconds with antibacterial (we use surgical scrub) soap.

Do not get stitches for a bite, it will seal the infection in.

My bite was serious, but did not require antibiotics. The Dr. I saw said that he would not know what type to prescribe and if I had started on them then (about 4 hours after the bite) I might have to finish a course of antibiotics for no reason.
He told me that the preventative treatment I gave the wounds right after it happened was probably the best thing I could have done. I stuck it under warm tap water, made sure it continued bleeding, then washed it well with surgical scrub vigorously. Yes, it is painful to wash a wound with soap, but hey, I didn't get an infection and luckily, no antibiotics either!

Mmm, cat bite. Two girls from school ended up in the hospital because of those (they didn't get bit at school, but at work in a vet clinic) and one almost lost 3 of her fingers, the other had to stay 2 weeks in the hospital, both because of severe infection.
Cat bites and scratches are scary. Evil little things.

Apparently not all cats can cause infected bites, it depends on the cat. It also depends on where the bite is, if you have it on a joint its BAD; I was lucky my immune system is strong and the fangs missed everything but muscle, the Doc. at the walk in clinic said my initial care of washing it, letting it bleed, and dousing it in soap and hydrogen peroxide was the best thing I could have done for it, and didn't even prescribe me antibiotics. He then commented, "if you think a cat bite is bad, you have no idea how dirty human bites are"

I can only please one person per day. Today is not your day, tomorrow doesn't look good either.
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"You didn't know of the magical powers of the break stick? It's up there with genies and Harry Potter as far as magic levels go." SisMorphine 01/07/07

I checked with a Dr in New York. It is NOT manditory for them to report bites. It is also not manditory for you to report a bite. If you report it, they can not force you to give any information about the dog.

The only thing they have to report is if you could have been exposed to rabies, but you can refuse medical treatment if you want.

Michelle

Inside me is a thin woman trying to get out. I usually shut the bitch up with a martini.

Even if dog bites do not break the skin (or only make small punctures that don't seem like a "big deal") still keep an eye on them. I learned this the hard way.

One year ago I received a dog bite on my lower right leg that left small punctures through the bite suit. The punctures were small enough that I did not notice them upon immediate inspection. Silly me thought that it would be okay, despite feeling something go 'wrong' when the dog first gripped and pulled away from my leg. The leg started swelling immediately and grew quickly - by the time I got home an hour or so later it was larger than a softball. The area was numb to the touch. This is when I should have gone to the doctor. But I didn't. I spent a week watching a huge bruise develop and go through many changes in color. The swelling did not decrease during this time and the area remained numb to the touch and felt funny (I don't know how else to describe it) around the edges. During the tail end of that week I experienced an increase in pain when standing and walking around.

Finally, I went to the doctor. I had developed a staph infection in my leg and there was some concern due to the close proximity of the tendon. I was told to watch for drop foot -difficulty lifting the foot. If that happens you should definitely go the doctor. Because I waited so long the blood that had spilled inside the leg had calcified and I was warned that I could potentially throw a clot. X-rays were taken to rule out a broken bone and I was put on several weeks worth of antibiotics. I was also put on bed rest.

It has been one year and I still have remnants of the bite. The area is discolored and normal feeling has not returned. There is still an amount of calcified blood sitting there, though it is significantly less. If a dog bites me just right while we are working it hurts and I do sometimes worry (but not all that often) about a clot being severed and thrown. No one knows if the area will ever return to normal.

The moral of the story....GO TO THE DOCTOR!! If in doubt, go to the doctor! It is way better to go for something that may not need it, than to wait for something that does.

And yes, I am that stupid and cavalier person. But I won't make the same mistake again.

Holy crap. That's crazy, a bite you didn't even notice upon inspection?!? Must have had some wicked stuff growing in that bite suit... Did the dog's teeth actually pierce the bite suit, or was it from a very strong abrasion?

It wasn't my suit. This was before I even had a suit. I was borrowing it from another guy who was at the event and he had been working in it all day every day for a week. When I put it on it STUNK!

There were two small puncture wounds that I found later and there was some friction burn from the inside of the suit. The doctor thinks the infection came from the suit and probably had nothing to do with the bite itself.

Malli wrote:I just recently was bitten by a cat at work. I have 4 puncture marks that have now scarred and they were DEEP.We have rules at work:

If you get bit, run it under water, let it bleed, let it bleed let it bleed. Then wash the wounds 3 times for 30 seconds with antibacterial (we use surgical scrub) soap.

Do not get stitches for a bite, it will seal the infection in.

My bite was serious, but did not require antibiotics. The Dr. I saw said that he would not know what type to prescribe and if I had started on them then (about 4 hours after the bite) I might have to finish a course of antibiotics for no reason. He told me that the preventative treatment I gave the wounds right after it happened was probably the best thing I could have done. I stuck it under warm tap water, made sure it continued bleeding, then washed it well with surgical scrub vigorously. Yes, it is painful to wash a wound with soap, but hey, I didn't get an infection and luckily, no antibiotics either!

Malli

At work or at home I always soak immediately in a chlorhex (surgical scrub) solution for about 3 minutes and keep it open as long as possible. I only cover it to keep it clean at night or when working. I don't get Abs unless I see it looking infected, most of the time, except one cat bite, they've resolved on their own.

I also try to flush it out if deep enough with an ointment or solution and yes, it "*@F^&*in" hurts but to me its worth it.

Ryder - Rescue APBT Panser on a Roll - APBT (American Bully?)Gretchen - the red headed cat that thinks shes a dogPrudence - the new cat on the block to put the dogs in their place!Punchlines Better Than Lojac - APBT (RIP)

Malli wrote:My bite was serious, but did not require antibiotics. The Dr. I saw said that he would not know what type to prescribe and if I had started on them then (about 4 hours after the bite) I might have to finish a course of antibiotics for no reason.

Then that Dr. needs to brush up on his medicine.

(I'm not saying I don't believe he said that, but he doesn't know what to give you? That's why he's a doctor. Sheesh! )

Michelle

Inside me is a thin woman trying to get out. I usually shut the bitch up with a martini.

ya, my coworkers had the same response at the time, they were not impressed. Apparently best meds of choice are penicillin, if I remember correctly. My guess is he was trying to avoid prescribing unneeded antibiotics, but it was frustrating; particularly since I waited 5 hrs in emerg. and finally gave up and went to a walk in clinic all for nothing.Lucky for me (especially considering it was a CAT bite), I healed well.

I can only please one person per day. Today is not your day, tomorrow doesn't look good either.
_______________________________________
"You didn't know of the magical powers of the break stick? It's up there with genies and Harry Potter as far as magic levels go." SisMorphine 01/07/07

Once I had a deep one from cat, I sort of shredded it open a bit more (cause there was a flap, closing on it's own) and used an iv catheter (without the stylet) to flush chlorex inside of it. It burned like hell but never got infected.

Usually the best antibiotics are clavulanic acid and amoxicillin, just like clavamox. I've used some clavaseptin from work before (directed by my vet, who got the info from his dr. friend, so yes it's safe unless you have allergies), nothing like a beef flavored chewable caplet twice a day.